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Also known as: Clostridium perfringens type D enterotoxaemia
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Also known as: '''''Clostridium perfringens type D enterotoxaemia
 
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==Description==
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==Introduction==
 
[[Image:clostridium perfringens.jpg|thumb|right|200px|Clostridium Perfingens. Source: Wikimedia Commons; Author:Don Stalons (1974)]]
 
[[Image:clostridium perfringens.jpg|thumb|right|200px|Clostridium Perfingens. Source: Wikimedia Commons; Author:Don Stalons (1974)]]
 
Pulpy kidney is a common, peracute and usually fatal enterotoxaemia of sheep of all ages, caused by the &epsilon; toxin of ''Clostridium perfringens'' type D. ''Clostridium perfringens'' type D causes the highest number of sheep fatalities due to clostridial disease<sup>1</sup>. It is a large, gram positive, anaerobic bacillus that is ubiquitous in the environment and commensalises the gastrointestinal tract of most mammals, although type D is found less abundantly in healthy animals than the other genotypes<sup>2</sup>. Five genotypes of ''Clostridium perfringens'' exist, named A-E, and all genotypes produce potent exotoxins. There are 12 exotoxins in total, some of which are lethal and others which are of minor significance<sup>3</sup>. These are produced as pro-toxins, and are converted to their toxic forms by digestive enzymes such as trypsin. The enterotoxaemias are a group of diseases caused by proliferation of ''C. perfringens'' in the lumen of the gastrointestinal tract and excessive production of exotoxin.
 
Pulpy kidney is a common, peracute and usually fatal enterotoxaemia of sheep of all ages, caused by the &epsilon; toxin of ''Clostridium perfringens'' type D. ''Clostridium perfringens'' type D causes the highest number of sheep fatalities due to clostridial disease<sup>1</sup>. It is a large, gram positive, anaerobic bacillus that is ubiquitous in the environment and commensalises the gastrointestinal tract of most mammals, although type D is found less abundantly in healthy animals than the other genotypes<sup>2</sup>. Five genotypes of ''Clostridium perfringens'' exist, named A-E, and all genotypes produce potent exotoxins. There are 12 exotoxins in total, some of which are lethal and others which are of minor significance<sup>3</sup>. These are produced as pro-toxins, and are converted to their toxic forms by digestive enzymes such as trypsin. The enterotoxaemias are a group of diseases caused by proliferation of ''C. perfringens'' in the lumen of the gastrointestinal tract and excessive production of exotoxin.
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In healthy animals, there is a balance between multiplication of ''Clostridium perfringens'' and its passage in the faeces. This ensures that infection is maintained at a low level.  However, ''C. perfringens'' is saccharolytic and is therefore able to multiply rapidly when large quantities of fermentable carbohydrate are introduced to the anaerobic conditions of the abomasum and small intestine, leading to build-up of exotoxin. Gut statis, for example due to insufficient dietray fibre or a high gastrointestinal parasite burden, can also contribute to the accumulation of toxins.  
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In healthy animals, there is a balance between multiplication of ''Clostridium perfringens'' and its passage in the faeces. This ensures that infection is maintained at a low level.  However, ''C. perfringens'' is saccharolytic and is therefore able to multiply rapidly when large quantities of fermentable carbohydrate are introduced to the anaerobic conditions of the abomasum and small intestine, leading to build-up of exotoxin. Gut statis, for example due to insufficient dietary fibre or a high gastrointestinal parasite burden, can also contribute to the accumulation of toxins.  
    
Enterotoxaemia due to ''Clostridium  perfringens''  type D causes sudden death in sheep of any age, particularly well-grown lambs of between 4 and 10 weeks of age and fattening lambs of 6 months to 1 year old<sup>3</sup>. Rams are also susceptible when they are subjected to an increased plane of nutrition prior to mating. The condition is associated with a change in diet, for example the introdcution of lush grass or high proportions of concentrate. This leads to rapid multiplication of the bacterium and excessive production of its &epsilon; toxin. &epsilon; toxin causes loss of epithelial integrity, increasing the permeability of the intestinal mucosa to facilitate its rapid absorption<sup>1</sup>. It then gives degeneration of vascular endothelium elsewhere, particularly in the brain, leading to increased capiliary permeability and oedema formation<sup>2, 4</sup>. Hepatic glycogen is mobilised by &epsilon; toxin and so hyperglycaemia and glycosuria are frequently seen<sup>1</sup>.Endothelial damage results in protein-rich effusions. The incidence of pulpy kidney declined over the past 25 years due to the widespread use of clostridial vaccines<sup>5</sup>, but the condition is becoming a problem again as complacency reduces the use of vaccination. At its most extreme, pulpy kidney can cause losses of 10-15% of the lamb crop. The disease can also occur in cattle, but this is rare<sup>2</sup>.
 
Enterotoxaemia due to ''Clostridium  perfringens''  type D causes sudden death in sheep of any age, particularly well-grown lambs of between 4 and 10 weeks of age and fattening lambs of 6 months to 1 year old<sup>3</sup>. Rams are also susceptible when they are subjected to an increased plane of nutrition prior to mating. The condition is associated with a change in diet, for example the introdcution of lush grass or high proportions of concentrate. This leads to rapid multiplication of the bacterium and excessive production of its &epsilon; toxin. &epsilon; toxin causes loss of epithelial integrity, increasing the permeability of the intestinal mucosa to facilitate its rapid absorption<sup>1</sup>. It then gives degeneration of vascular endothelium elsewhere, particularly in the brain, leading to increased capiliary permeability and oedema formation<sup>2, 4</sup>. Hepatic glycogen is mobilised by &epsilon; toxin and so hyperglycaemia and glycosuria are frequently seen<sup>1</sup>.Endothelial damage results in protein-rich effusions. The incidence of pulpy kidney declined over the past 25 years due to the widespread use of clostridial vaccines<sup>5</sup>, but the condition is becoming a problem again as complacency reduces the use of vaccination. At its most extreme, pulpy kidney can cause losses of 10-15% of the lamb crop. The disease can also occur in cattle, but this is rare<sup>2</sup>.
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==Treatment and Control==
 
==Treatment and Control==
   
The first sign of pulpy kidney is sudden death, and so there is often no opportunity for treatment. Even if affected animals are found prior to death, treatment is usually unrewarding as organs are irreversibly damaged by toxins by the time signs present<sup>3</sup>. Instead, a definitive diagnosis should be pursued before greater losses occur, and the farmer should be encouraged to submit the carcase for further investigations.
 
The first sign of pulpy kidney is sudden death, and so there is often no opportunity for treatment. Even if affected animals are found prior to death, treatment is usually unrewarding as organs are irreversibly damaged by toxins by the time signs present<sup>3</sup>. Instead, a definitive diagnosis should be pursued before greater losses occur, and the farmer should be encouraged to submit the carcase for further investigations.
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Control of pulpy kidney involves avoiding the fators that can precipitate disease. Diets should not be changed suddenly and concentrate feeding should always be introduced slowly<sup>1</sup>. Feeding of whole grain slows the transit of feed to the small intestine, so cereals should be fed in this form. ''C.. perfringens'' type D is ubiquitously distributed and so management measure will never completely prevent disease. The best method of disease prevention is vaccination.
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Control of pulpy kidney involves avoiding the factors that can precipitate disease. Diets should not be changed suddenly and concentrate feeding should always be introduced slowly<sup>1</sup>. Feeding of whole grain slows the transit of feed to the small intestine, so cereals should be fed in this form. ''C.. perfringens'' type D is ubiquitously distributed and so management measure will never completely prevent disease. The best method of disease prevention is vaccination.
    
Before the development of modern clostridial vaccines in the 1970s, losses of up to 15% of the lamb crop could occur due to pulpy kidney<sup>3</sup>. The vaccines used today are effective against a variety of clostridial diseases and some vaccines are combined for effects against ''Pasteurella''. The vaccines consist of toxoids which are inactivated forms of the toxins produced by clostridial organisms. The principles of vaccination are the same whether a clostridium-only or ''Pasteurella''-combined product is used: a sensitising dose must be given 4-6 weeks before a second, confirming dose<sup>3</sup>. As immunity wanes over a period of a year, booster doses are required annually. Therefore, ewes should receive the primary vaccination course before entering the breeding flock and an annual booster approximately six weeks before lambing. Timing the booster vaccination in this way affords passive protection to lambs until they are around 16 weeks of age. Lambs born to unvaccinated ewes should be vaccinated between 3 and 12 weeks old, with a second injection given at least four weeks later.
 
Before the development of modern clostridial vaccines in the 1970s, losses of up to 15% of the lamb crop could occur due to pulpy kidney<sup>3</sup>. The vaccines used today are effective against a variety of clostridial diseases and some vaccines are combined for effects against ''Pasteurella''. The vaccines consist of toxoids which are inactivated forms of the toxins produced by clostridial organisms. The principles of vaccination are the same whether a clostridium-only or ''Pasteurella''-combined product is used: a sensitising dose must be given 4-6 weeks before a second, confirming dose<sup>3</sup>. As immunity wanes over a period of a year, booster doses are required annually. Therefore, ewes should receive the primary vaccination course before entering the breeding flock and an annual booster approximately six weeks before lambing. Timing the booster vaccination in this way affords passive protection to lambs until they are around 16 weeks of age. Lambs born to unvaccinated ewes should be vaccinated between 3 and 12 weeks old, with a second injection given at least four weeks later.
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==Literature Search==
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[[File:CABI logo.jpg|left|90px]]
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Use these links to find recent scientific publications via CAB Abstracts (log in required unless accessing from a subscribing organisation).
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<br><br><br>
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[http://www.cabdirect.org/search.html?q=title%3A%28pulpy+kidney%29+OR+title%3A%28Clostridium+perfringens+type+D+enterotoxaemia%29 Pulpy Kidney publications]
    
==Links==
 
==Links==
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[[Category:Enteropathogenic_and_Enterotoxaemic_Clostridia]][[Category:Sheep]][[Category:Goat]]
 
[[Category:Enteropathogenic_and_Enterotoxaemic_Clostridia]][[Category:Sheep]][[Category:Goat]]
 
[[Category:Enteritis,_Bacterial]][[Category:Enteritis,_Catarrhal]]
 
[[Category:Enteritis,_Bacterial]][[Category:Enteritis,_Catarrhal]]
[[Category:To_Do_-_Lizzie]]
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[[Category:Expert_Review]]
[[Category:To_Do_-_Review]]
 
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